Browsing by Author "Shrestha, Jyoti Baba"
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Publication Clinical Presentation and Staging of Retinoblastoma Patients(Institute of Medicine, Tribhuvan University, 2024) Shrestha, Jyoti BabaAbstract: Introduction Retinoblastoma is the common curable primary intraocular malignancies of childhood occurring in approximately 1 in 18,000 live births. The burden of disease is of great importance because early detection and management will have a lifelong impact on other domains of development in these children. The purpose of this study is to determine the clinical presentation and staging of retinoblastoma patients. Methods This was a hospital-based descriptive study conducted at BP Koirala Lions Centre for Ophthalmic Studies. Children diagnosed with retinoblastoma were enrolled by purposive sampling method. After obtaining informed written consent, data was taken in semi-structured proforma. Data was analysed in the SPSS version 21.0. Results A total of 17 cases of retinoblastoma were enrolled in this study. Majority of the cases were male, belonging to low-class family, and from rural areas. Sixty four percent of participants had leukocoria, followed by proptosis (18%) and red eye (9%). One eye was affected in 12 (71%) cases and both eyes were affected in 5 (29%) cases. The highest number of patients was from Province 2 (35%) and they belonged to the upper caste (29%). Group D and group E lesions were seen in 37% and 50% of cases respectively whereas stage 1 disease was seen in 86%. Conclusion Leukocoria was the most common clinical presentation. More than 80% of tumours were in advanced Group D and Group E category. The study highlights the delayed presentation of cases to treatment because of lack of awareness, ignorance, poverty, illiteracy and limited access to health care facilities.Publication Evaluation of Peripapillary and Macular Nerve Fiber Layer Thickness in Paediatric Glaucoma Suspects(Nepal Paediatric Society (JNPS), 2022) Gautam, Pragati Adhikari; Dahal, Hira Nath; Shrestha, Jyoti BabaAbstract: Introduction: Glaucoma patients are known to have optic disc cupping, leading to loss of retinal ganglion cell axons. This peripapillary nerve thinness is known to be associated with glaucoma in adult patients. Hence, we intended to evaluate the peripapillary and macular nerve fiber thickness in eyes of pediatric glaucoma suspects using spectral domain optical coherence tomography (OCT). Methods: This cross-sectional analytical study included 44 eyes of 22 paediatric glaucoma suspects, who were compared with 40 eyes of 20 normal paediatric eyes. Pearson correlation coefficients were calculated to assess the relations between the peripapillary retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC). Receiver Operating Characteristics (ROC) curve was plotted for OCT parameters in both the groups along with area under the curve (AUC) calculation. P values < 0.05 were considered as statistically significant. Results: We found the RNFL to be thickest in the superior, inferior, nasal and temporal quadrants in both glaucoma suspects and normal group. When compared among quadrants in RNFL, all the values in different quadrants were statistically significant from each other and in between groups with p < 0.01. The RNFL thickness was statistically different in glaucoma when compared with normal in superior, temporal, and nasal quadrants however, no statistically significant difference was found in inferior quadrant RNFL. The largest AUC for discrimination of glaucoma suspect eyes from normal in peripapillary RNFL in was nasal quadrant in right eye, followed by temporal quadrant whereas it was largest in superior followed by nasal quadrants then average in left eye. However, AUC for discrimination of glaucoma suspects from normal in GCC was poor. Conclusions: Glaucoma suspect paediatric eyes showed significant thinning in peripapillary nerve fiber layer thickness compared to normal subjects.